Cardio-respiratory values during recovery from exercise in soccer Spanish leagues.

OBJECTIVE: In this cross-sectional study, we compared Spanish division one (n = 114) and division two (n = 80) soccer players in terms of their cardio-respiratory response during recovery following a maximum laboratory effort test. APPROACH: Following the maximum laboratory effort protocol, we measured oxygen consumption ([Formula: see text]), heart rate (HR), and ventilation ([Formula: see text]) during recovery. MAIN RESULTS: Over the first 60 s of recovery, no significant differences were seen in either [Formula: see text] (28.7 versus 28.3 ml/kg/m, in division one and two players, respectively), HR, or [Formula: see text] (p > 0.05). After 90 s, however, significant differences appeared between the players of the two divisions (p < 0.01), although not among playing positions. Significant differences in [Formula: see text] (21.1 versus 26.0 ml/kg/m, in division one and two players, respectively) and HR were still apparent at 180 s into the recovery period. The change in professional soccer players' cardio-respiratory values over the recovery period following maximum effort are independent of the position played, but are associated with the division in which a player competes. Second division players show significantly higher [Formula: see text] and HR values than first division players at 180 s into the recovery period. SIGNIFICANCE: These differences might influence performance in soccer and in other athletes whose sports require intermittent bouts of maximum effort and consequently times to repeat high-intensity efforts as short as possible.

Estudio comparativo entre deportes simétricos y asimétricos mediante análisis estructural estático en deportistas adolescentes / Comparative study between symmetrical and asymmetrical sports by static structural analysis in adolescent athletes

En los exámenes médicos preparticipación deportiva, el análisis de las estructuras anatómicas que no están directamente relacionadas con el deporte en cuestión, suele ser más superficial. Un examen más detallado del aparato locomotor podría revelar la existencia de ciertas anomalías que, en ocasiones pueden pasar desapercibidas. El objetivo de este estudio es describir la prevalencia de trastornos estructurales del aparato locomotor en una población de deportistas adolescentes de élite de la Comunidad de Madrid. Establecer la relación de alteraciones con la práctica de deportes simétricos o asimétricos. Estudio transversal descriptivo. Nivel de evidencia II-III. Nuestra población de estudio incluye deportistas pertenecientes al plan de tecnificación de la Comunidad de Madrid: 102 deportistas, 66 hombres y 36 mujeres con edades comprendidas entre 12 y 19 años. Un grupo control está compuesto por deportistas de natación, deporte considerado simétrico y el segundo grupo por deportistas practicantes de deportes considerados asimétricos: esgrima y bádminton. Los deportistas fueron examinados siguiendo un método cegado por tres diferentes especialistas que utilizaron el mismo protocolo. Se ha empleado el contraste de hipótesis para variables cualitativas, con un nivel de confianza del 95% (p<0,05). Noventa y seis deportistas (94,1%) presentaron algún tipo de alteración estructural y /o postural en los exámenes médicos preparticipación deportiva. No encontramos correlación significativa (p<0,05) ) entre los diferentes deportes en las alteraciones en la columna vertebral, las rodillas, las extremidades y la huella plantar, independientemente fueran simétricos o asimétricos (p<0,05). Conclusiones: Nuestro estudio muestra una alta prevalencia de variaciones estructurales en los adolescentes que practican deporte de alto nivel. No encontramos relación entre practicar un deporte asimétrico y la prevalencia de escoliosis u otra alteración músculo-esquelética

In pre-participative sports medical examinations, the analysis of the anatomical structures that are not directly related to the sport in question, is usually more superficial. A more detailed assessment of the locomotive system may reveal the existence of certain anomalies, which may occasionally go unnoticed. The aim of this study is to describe the prevalence of structural disorders of the locomotive system among elite-level athletes from the Community of Madrid. To establish the relationship between alterations and practising symmetrical or asymmetrical sports. Descriptive cross-sectional study Level of evidence II-III Our study sample includes athletes that are members of the Community of Madrid Sports Technification Plan. 102 athletes, 66 males and 36 females aged between 12 and 19 years. One control group comprises swimming athletes, a sport considered to be symmetrical, and the second group comprises athletes practising sports considered to be asymmetrical: fencing and badminton. The athletes were examined following a blind method by three different specialists using the same protocol. Hypothesis contrasting has been used for qualitative variables, with a 95% confidence level (p<0.05). Ninety-six athletes (94.1%) displayed some kind of structural and/or postural alteration in the pre-participative sports medical examinations. No significant correlation was found (p<0.05) between the different sports on alterations to the spine, knees, extremities and footprint, regardless of whether they were symmetrical or asymmetrical (p<0.05). Conclusions: Our study revealed a high prevalence of structural variation in high-level adolescent athletes. No relationship was found between practising an asymmetrical sport and the prevalence of scoliosis or other muscular-skeletal alterations

What is normal bladder neck anatomy?

INTRODUCTION AND HYPOTHESIS: Functional anatomy of the bladder neck and proximal urethra has been studied extensively because of the belief that it is important for urinary continence. The aim of this study was to explore the limits of normality for pelvic floor ultrasound parameters of bladder neck and urethral mobility associated with stress urinary incontinence (SUI) and urodynamic stress incontinence (USI). METHODS: A retrospective study was conducted on 589 women seen for urodynamic testing in a tertiary urogynaecology clinic. All women were assessed following a protocol including interview, clinical examination, flowmetry, urodynamic testing and 4D pelvic floor ultrasound. Volume data sets were analysed offline to assess for bladder neck descent (BND), urethral rotation and the retrovesical angle (RVA) on maximal Valsalva. RESULTS: After excluding women with previous incontinence or prolapse surgery, 429 datasets were available. SI was significantly associated with the RVA (p = 0.033) and BND (p = 0.036); USI was associated with urethral rotation (p = 0.021) and BND (p < 0.001). On multivariate logistic regression analysis, controlling for confounders including age, BMI, parity, previous hysterectomy and maximal urethral pressure, the association between SUI and BND remained significant (OR [per 10 mm] = 1.23; 95 % CI: 1.01 to 1.51; p = 0.043), as did the association between USI and BND (OR [per 10 mm] = 1.58; 95 % CI: 1.3 to 1.91; p < 0.001). ROC statistics for BND suggested a cut-off of 25 mm in describing the limit of normality. CONCLUSIONS: Measures of functional bladder neck anatomy are weakly associated with SUI and USI (with association between BND and USI being the strongest). It is suggested that a BND of 25 mm or higher be defined as abnormal ("hypermobile") on the basis of its association with USI.

Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics.

OBJECTIVES: The administration of empirical anticholinergic treatment is widespread in women with urinary incontinence and has produced varied results. The objective of our paper is to determine the effectiveness of anticholinergics for the treatment of female urinary incontinence and to determine by urodynamics the possible causes that may explain the resistance to anticholinergics to obtain urodynamic predictors of success or failure. METHODS: We evaluated 182 women over 14 years of age with urinary incontinence that had previously been treated with anticholinergics for at least three months. The patients underwent a complete medical history including clinical history, physical examination, and urodynamic and lower urinary tract video-radiologic studies. Statistical analysis was performed using SPSS 17.0 for Windows. RESULTS: Clinical therapeutic efficacy was demonstrated in 39.6% of cases. Cystometric bladder capacity was decreased in 89.2%of patients that did not improve clinically with anticholinergics (p=0.01). Detrusor overactivity was urodynamically demonstrated in 51% of cases (p=0.05) among patients without clinical improvement with anticholinergic treatment. This hyperactivity was demonstrated during early bladder filling (<100ml). Urodynamic stress urinary incontinence (SUI) was demonstrated in 26.5% of patients without clinical improvement after treatment (p=0.04). Lower urinary tract obstruction was urodynamically demonstrated in 20.6% of patients with no clinical improvement (p=0.05). Urodynamic data did not demonstrate a relationship between detrusor overactivity, a high-grade cystocele ( 37.4% of total), and irregular bladder morphology (11.5% of total). CONCLUSIONS: It is important to conduct urodynamic study before starting anticholinergic treatment of females with urinary incontinence to identify therapeutic data of poor prognosis, such as SUI and lower urinary tract obstruction, thus optimizing the therapeutic efficacy of anticholinergics.

Aproximación urodinámica al tratamiento refractario de la incontinencia urinaria femenina con anticolinérgicos / Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics

OBJETIVO: Está muy difundida la aplicación del tratamiento anticolinérgico empírico en la incontinencia urinaria femenina con diferentes resultados. En nuestro trabajo se ha investigado la eficacia de los anticolinérgicos en el tratamiento de la incontinencia urinaria femenina, así como determinar urodinámicamente las posibles causas que expliquen la resistencia al mismo e intentar obtener predictores urodinámicos de éxito o fracaso. MÉTODOS: Se han evaluado 182 casos de mujeres mayores de 14 años con incontinencia urinaria, que habían sido tratadas con anticolinérgicos previamente durante al menos tres meses, a las que se les realizó historia clínica completa con anamnesis, exploración física, estudio urodinámico y videorradiológico del tracto urinario inferior. El análisis estadístico de los datos se realizó con el programa SPSS 17.0 para Windows. RESULTADOS: Se demostró eficacia terapéutica clínica en el 39,6% de los casos. La capacidad vesical cistomanométrica estaba disminuida en el 89,2% de las pacientes que no mejoraron clínicamente con los anticolinérgicos (p=0,01). La hiperactividad del detrusor fue demostrada urodinámicamente en el 51% de los casos (p=0,05) entre las pacientes sin mejoría clínica con el tratamiento anticolinérgico. Esta hiperactividad se demostró precozmente en el llenado vesical (<100ml). Se demostró urodinámicamente IUE en el 26,5% de las pacientes sin mejoría clínica postratamiento (p=0,04). Se demostró urodinámicamente obstrucción del TUI en el 20,6% de los casos sin mejoría clínica (p=0,05). Los datos videourodinámicos no demostraron una relación entre la hiperactividad del detrusor, el cistocele de alto grado (37,4% del total) y la morfología vesical irregular (11,5% del total)(AU)

CONCLUSIONES: Es importante la realización de un estudio urodinámico previo al tratamiento anticolinérgico de la incontinencia urinaria femenina para identificar los datos de mal pronóstico terapéutico como son la incontinencia urinaria de esfuerzo y la obstrucción del tracto urinario inferior, optimizando así la eficacia terapéutica de los anticolinérgicos(AU)

OBJECTIVES: The administration of empirical anticholinergic treatment is widespread in women with urinary incontinence and has produced varied results. The objective of our paper is to determine the effectiveness of anticholinergics for the treatment of female urinary incontinence and to determine by urodynamicsthe possible causes that may explain the resistance to anticholinergics to obtain urodynamic predictors of success or failure. METHODS: We evaluated 182 women over 14 years of age with urinary incontinence that had previously been treated with anticholinergics for at least three months. The patients underwent a complete medical history including clinical history, physical examination, and urodynamic and lower urinary tract video-radiologic studies. Statistical analysis was performed using SPSS 17.0 for Windows. RESULTS: Clinical therapeutic efficacy was demonstrated in 39.6% of cases. Cystometric bladder capacity was decreased in 89.2% of patients that did not improve clinically with anticholinergics (p=0.01). Detrusor overactivity was urodynamically demonstrated in 51% of cases (p = 0.05) among patients without clinical improvement with anticholinergic treatment. This hyperactivity was demonstrated during early bladder filling (<100ml). Urodynamic stress urinary incontinence (SUI) was demonstrated in 26.5% of patients without clinical improvement after treatment (p=0.04). Lower urinary tract obstruction was urodynamicallydemonstrated in 20.6% of patients with no clinical improvement (p=0.05). Urodynamic data did not demonstrate a relationship between detrusor overactivity, a high-grade cystocele (37.4% of total), and irregular bladder morphology (11.5% of total). CONCLUSIONS: It is important to conduct urodynamic study before starting anticholinergic treatment of females with urinary incontinence to identify therapeutic data of poor prognosis, such as SUI and lower urinary tract obstruction, thus optimizing the therapeutic efficacy of anticholinergics(AU)